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Permit Job #3830 / 2 C 7 WASHINGTON COUN 0, ELECTRICAL PERMIT 411111% Department of La • II se & Transportation liiiiF Electrical Ins s = ton Section APPLICATION 155 North ' t Avenue, #350 -12 Hillsbo , , Oregon 97124 Information: (503 .40 -3470 Fax: (503) 693 -4412 PLEASE PRINT Permit Please complete all sections, 1 through 5. Number IL C 6 15- 0) 8 tw Date 7 )20195 1. Location of installation 4. Complete Fee Schedule below Address 6650 S .W Redwood lane Number of inspections per permit allowed Building City Tigard Suite te No. - -2•543-- 0 Service included: Items Cost(ea.) Sum Tenant Name A. Residential - per unit (if commercial) Imagebui lders 1000 sq. ft. or less $110.00 4 Map No. Tax Lot Each additional 500 sq. ft or portion thereof $25.00 Thomas Map Book: Page: Section: Each Energy $25.00 1 P 9 Each h Manuf'd Home or Modular Directions Dwelling Service or Feeder $68.00 2 I � B. Services or Feeders Commercial © 1 Residential I Installation, alterations or relocation 200 amps or less 2 $60.00 120.00 2 2a. Contractor installation only: 201 amps to 400 amps $80.00 2 401 amps to 1000 amps $120.00 2 Electrical Contractor Bachofner Electric 601 amps to 1000 amps $180.00 2 Address 5 5 S . E Main St. Over 1000 amps or volts $340.00 2 City Portland State Or ZIP 97214 • Reconnect only $50.00 2 Date 7/18/95 Job Number 3830 Property Owner C. Temporary Services or Feeders Contractor's License No. 26-451 C Installation, alteration or relocation Contractor's Board Reg. No. 4 4 569 200 amps or less $50.00 2 201 amps to 400 amps $75.00 2 Si Signature of Sur. Elec'n G(/ ,,._� 401 amps to 600 amps $1 00.00 2 9 P Over 600 amps to 1000 volts see "B" above License No. 2808S Phone No. 233- 06 D. Branch Circuits 2b. For owner installations: New alteration or extension per panel a) The fee for branch circuits with Print Owner's Name Phone No. purchase of service or feeder fee. Each branch circuit 4 4 $5.00 220 . 0 0 2 Address b) The fee for branch circuits without purchase of service or feeder fee. City State Zip First branch circuit $35.00 2 Each add'nl branch circuit $5.00 2 The installation is being made on property I own E. Miscellaneous (Service or Feeder not included) which is not intended for sale, lease or rent. Each pump or irrigation circle $40.00 2 Each sign or outline lighting $40.00 2 Owner's Signature Signal circuit(s) or a limited energy panel, alteration 3. Plan Review section (if required) or extension $40.00 2 Please check appropriate item and enter fee in section 5B. F. Each additional inspection over the allowable 4 or more residential units in one structure in any of the above Per inspection - $35.00 Service and feeder, 800 amps or more Per hour - $55.00 System over 600 volts nominal In Plant $55.00 Classified area or structure containing special l occupancy as described in N.E.C. Chapter 5 5. Fees Submit 2 sets of plans with application where any of the A. Enter total of above fees $ 34 . 00 ('a above apply. Not required for temporary construction 5% Surcharge (.05 X total fees) $ 1 7 . 00 00 services. Subtotal $ This permit becomes null and void if the work authorized by the permit is B. Enter 25% of line A for not commenced within 180 days from date of Issuance of such permit or Plan Review if required (Section 3) $ + 1 if the work authorized is suspended or abandoned at any time after work $ t 1 Is commenced for a period of 180 days. Electrical Permits are non- Subtotal $ 6- refundable and non - transferable. ❑ Trust Account For inspections call Balance Due $ 357.00 -- 681 -3699 or 681 -3698 24 -hour recorder, one working day in advance of need 8L28 • 3/95 i 6/10/99 Activities for Case #: ELC95 -00186 1:15:47 PM Assigned Hold Updated Activity Description Date 1 Date 2 Date 3 To Done By Disp. Level By Updated Notes ELCC001 Application received 7/19/95 SUE RECD TMP 12/5/95 ELCC003 Permit created 7/19/95 SUE RECD TMP 12/5/95 ELCC500 (F)Issue permit 7/19/95 SUE PASS TMP 12/5/95 ELCC800 Case Finaled 3/8/96 MJR YES MJR 3/11/96 Page 1 of 1